ABSTRACT
BACKGROUND: In the ongoing COVID-19 pandemic, an increased incidence of ROCM was noted in India among those infected with COVID. We determined risk factors for rhino-orbito-cerebral mucormycosis (ROCM) post Coronavirus disease 2019 (COVID-19) among those never and ever hospitalized for COVID-19 separately through a multicentric, hospital-based, unmatched case-control study across India. METHODS: We defined cases and controls as those with and without post-COVID ROCM, respectively. We compared their socio-demographics, co-morbidities, steroid use, glycaemic status, and practices. We calculated crude and adjusted odds ratio (AOR) with 95% confidence intervals (CI) through logistic regression. The covariates with a p-value for crude OR of less than 0·20 were considered for the regression model. RESULTS: Among hospitalised, we recruited 267 cases and 256 controls and 116 cases and 231 controls among never hospitalised. Risk factors (AOR; 95% CI) for post-COVID ROCM among the hospitalised were age 45-59 years (2·1; 1·4 to 3·1), having diabetes mellitus (4·9; 3·4 to 7·1), elevated plasma glucose (6·4; 2·4 to 17·2), steroid use (3·2; 2 to 5·2) and frequent nasal washing (4·8; 1·4 to 17). Among those never hospitalised, age ≥ 60 years (6·6; 3·3 to 13·3), having diabetes mellitus (6·7; 3·8 to 11·6), elevated plasma glucose (13·7; 2·2 to 84), steroid use (9·8; 5·8 to 16·6), and cloth facemask use (2·6; 1·5 to 4·5) were associated with increased risk of post-COVID ROCM. CONCLUSIONS: Hyperglycemia, irrespective of having diabetes mellitus and steroid use, was associated with an increased risk of ROCM independent of COVID-19 hospitalisation. Rational steroid usage and glucose monitoring may reduce the risk of post-COVID.
Subject(s)
COVID-19 , Diabetes Mellitus , Hyperglycemia , Mucormycosis , Orbital Diseases , Antifungal Agents/therapeutic use , Blood Glucose , Blood Glucose Self-Monitoring , COVID-19/epidemiology , Case-Control Studies , Diabetes Mellitus/drug therapy , Diabetes Mellitus/epidemiology , Hospitalization , Humans , Hyperglycemia/complications , Hyperglycemia/drug therapy , Hyperglycemia/epidemiology , India/epidemiology , Middle Aged , Mucormycosis/drug therapy , Mucormycosis/epidemiology , Orbital Diseases/drug therapy , PandemicsABSTRACT
Coronavirus disease-2019 (COVID-19) is showing a wide spectrum of ocular manifestations. They are creeping from vision sparing to irreversible visual loss as a result of its thromboembolic events. Hypercoagulability associated with COVID-19 is also called "sepsis-induced coagulopathy" and may predispose to thromboembolic phenomenon that decides the morbidity and mortality of this pandemic. A 37-year-old man presented with no perception of light in the left eye with optic atrophy and macular pucker on fundus examination. Visual evoked potential showed extinguished P 100 wave. His past medical history revealed severe pneumonia secondary to severe acute respiratory syndrome-coronavirus-2 (SARS-CoV 2) infection about 3 months back.